Patient Access Representative

6 days ago


Columbia, South Carolina, United States Prisma Health Full time

Job Summary

We are seeking a highly skilled and detail-oriented Patient Access Specialist to join our team at Prisma Health. As a Patient Access Specialist, you will play a critical role in ensuring that patients receive high-quality care by collecting and verifying demographic and financial data, verifying insurance coverage, and initiating pre-authorization processes when required.

Key Responsibilities

  • Interviews and Data Collection

Interview patients or other sources to secure information relative to financial status, demographic data, and employment information. Enter accurate information into computer databases and access Sovera to ensure the most recent insurance card is on file.

Insurance Verification

Verify insurance coverage and benefits utilizing online eligibility or by telephone inquiry to the employer and/or third-party payor. Document all information obtained through insurance verification in the system.

Pre-Certification and Authorization

Initiate pre-certification processes as required according to departmental guidelines. Obtain signed waivers for cases where pre-certification is required but not yet obtained.

Payment and Collections

Receive payments and issue receipts, actively working toward collection goals. Maintain cash funds and verification logs, and make daily deposits according to departmental policies and procedures.

Reporting and Documentation

Prepare and distribute appropriate reports, documents, and patient identification items as required.

Communication and Patient Engagement

Communicate to patients their estimated financial responsibility and request payment prior to or at the time of service. Refer patients who may need extended terms to the Medical Services Payment Program and patients needing financial assistance to appropriate programs.

Requirements

  • Education

High School Diploma or equivalent.

Experience

2 years of experience in Admissions, Billing, Collections, Insurance, and/or Customer Service.

Certifications/Registrations/Licenses

N/A.

Skills and Experience

Basic computer skills, knowledge of office equipment, word processing, spreadsheets, database, data entry, and mathematical skills. Registration and scheduling experience and familiarity with medical terminology are preferred.

Work Environment

This is a non-management job that will report to a supervisor, manager, director, or executive. The work shift is day, and the location is Baptist, with the facility being 7001 Corporate and the department being Patient Access - Baptist.



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